Staff View: Data envelopment analysis for ambulance services of different service providers in urban and rural areas in Ministry of Health Malaysia

Data envelopment analysis for ambulance services of different service providers in urban and rural areas in Ministry of Health Malaysia

Introduction: Ambulance services are pivotal in any country's healthcare system. An efficient ambulance service not only decreases patient mortality rate but also allows resource prioritization for better outputs. This study aims to measure the efficiency of ambulance services provided by healt...

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Main Authors:	Mohd Hassan, Nor Zam Azihan, Bahari, Mohd Shahri, Aminuddin, Farhana, Mohd Nor Sham Kunusagaran, Mohd Shaiful Jefri, Zaimi, Nur Amalina, Mohd Hanafiah, Ainul Nadziha, Kamarudin, Fakarudin
Format:	Article
Published:	Frontiers Media SA 2023
Online Access:	http://psasir.upm.edu.my/id/eprint/110198/ https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.959812/full
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spelling	my.upm.eprints.1101982024-09-04T04:00:36Z http://psasir.upm.edu.my/id/eprint/110198/ Data envelopment analysis for ambulance services of different service providers in urban and rural areas in Ministry of Health Malaysia Mohd Hassan, Nor Zam Azihan Bahari, Mohd Shahri Aminuddin, Farhana Mohd Nor Sham Kunusagaran, Mohd Shaiful Jefri Zaimi, Nur Amalina Mohd Hanafiah, Ainul Nadziha Kamarudin, Fakarudin Introduction: Ambulance services are pivotal in any country's healthcare system. An efficient ambulance service not only decreases patient mortality rate but also allows resource prioritization for better outputs. This study aims to measure the efficiency of ambulance services provided by health facilities in the Ministry of Health (MOH), Malaysia. Methods: This cross-sectional study analyzed the efficiency of 76 Decision-Making Units (DMUs) or health facilities, consisting of 62 health clinics and 14 hospitals. Data Envelopment Analysis (DEA) was used for computing efficiency scores while adopting the Variable Return to Scale (VRS) approach. The analysis was based on input orientation. The input was the cost of ambulance services, while the output for this analysis was the distance coverage (in km), the number of patients transferred, and hours of usage (in hours). Subsequent analysis was conducted to test the Overall Technical Efficiency (OTE), the Pure Technical Efficiency (PTE), the Scale Efficiency (SE), and the Return to Scale with the type of health facilities and geographical areas using a Mann-Whitney U-test and a chi-square test. Results: The mean scores of OTE, PTE, and SE were 0.508 (±0.207), 0.721 (±0.185), and 0.700 (±0.200), respectively. Approximately, 14.47% of the total health facilities were PTE. The results showed a significant difference in OTE and SE between ambulance services in hospitals and health clinics (p < 0.05), but no significant difference in PTE between hospitals and clinics (p > 0.05). There was no significant difference in efficiency scores between urban and rural health facilities in terms of ambulance services except for OTE (p < 0.05). Discussion: The ambulance services provided in healthcare facilities in the MOH Malaysia operate at 72.1% PTE. The difference in OTE between hospitals and health clinics' ambulance services was mainly due to the operating size rather than PTE. This study will be beneficial in providing a guide to the policymakers in improving ambulance services through the readjustment of health resources and improvement in the outputs. Frontiers Media SA 2023 Article PeerReviewed Mohd Hassan, Nor Zam Azihan and Bahari, Mohd Shahri and Aminuddin, Farhana and Mohd Nor Sham Kunusagaran, Mohd Shaiful Jefri and Zaimi, Nur Amalina and Mohd Hanafiah, Ainul Nadziha and Kamarudin, Fakarudin (2023) Data envelopment analysis for ambulance services of different service providers in urban and rural areas in Ministry of Health Malaysia. Frontiers in Public Health, 10. pp. 1-23. ISSN 2296-2565 https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.959812/full 10.3389/fpubh.2022.959812
institution	Universiti Putra Malaysia
building	UPM Library
collection	Institutional Repository
continent	Asia
country	Malaysia
content_provider	Universiti Putra Malaysia
content_source	UPM Institutional Repository
url_provider	http://psasir.upm.edu.my/
description	Introduction: Ambulance services are pivotal in any country's healthcare system. An efficient ambulance service not only decreases patient mortality rate but also allows resource prioritization for better outputs. This study aims to measure the efficiency of ambulance services provided by health facilities in the Ministry of Health (MOH), Malaysia. Methods: This cross-sectional study analyzed the efficiency of 76 Decision-Making Units (DMUs) or health facilities, consisting of 62 health clinics and 14 hospitals. Data Envelopment Analysis (DEA) was used for computing efficiency scores while adopting the Variable Return to Scale (VRS) approach. The analysis was based on input orientation. The input was the cost of ambulance services, while the output for this analysis was the distance coverage (in km), the number of patients transferred, and hours of usage (in hours). Subsequent analysis was conducted to test the Overall Technical Efficiency (OTE), the Pure Technical Efficiency (PTE), the Scale Efficiency (SE), and the Return to Scale with the type of health facilities and geographical areas using a Mann-Whitney U-test and a chi-square test. Results: The mean scores of OTE, PTE, and SE were 0.508 (±0.207), 0.721 (±0.185), and 0.700 (±0.200), respectively. Approximately, 14.47% of the total health facilities were PTE. The results showed a significant difference in OTE and SE between ambulance services in hospitals and health clinics (p < 0.05), but no significant difference in PTE between hospitals and clinics (p > 0.05). There was no significant difference in efficiency scores between urban and rural health facilities in terms of ambulance services except for OTE (p < 0.05). Discussion: The ambulance services provided in healthcare facilities in the MOH Malaysia operate at 72.1% PTE. The difference in OTE between hospitals and health clinics' ambulance services was mainly due to the operating size rather than PTE. This study will be beneficial in providing a guide to the policymakers in improving ambulance services through the readjustment of health resources and improvement in the outputs.
format	Article
author	Mohd Hassan, Nor Zam Azihan Bahari, Mohd Shahri Aminuddin, Farhana Mohd Nor Sham Kunusagaran, Mohd Shaiful Jefri Zaimi, Nur Amalina Mohd Hanafiah, Ainul Nadziha Kamarudin, Fakarudin
spellingShingle	Mohd Hassan, Nor Zam Azihan Bahari, Mohd Shahri Aminuddin, Farhana Mohd Nor Sham Kunusagaran, Mohd Shaiful Jefri Zaimi, Nur Amalina Mohd Hanafiah, Ainul Nadziha Kamarudin, Fakarudin Data envelopment analysis for ambulance services of different service providers in urban and rural areas in Ministry of Health Malaysia
author_facet	Mohd Hassan, Nor Zam Azihan Bahari, Mohd Shahri Aminuddin, Farhana Mohd Nor Sham Kunusagaran, Mohd Shaiful Jefri Zaimi, Nur Amalina Mohd Hanafiah, Ainul Nadziha Kamarudin, Fakarudin
author_sort	Mohd Hassan, Nor Zam Azihan
title	Data envelopment analysis for ambulance services of different service providers in urban and rural areas in Ministry of Health Malaysia
title_short	Data envelopment analysis for ambulance services of different service providers in urban and rural areas in Ministry of Health Malaysia
title_full	Data envelopment analysis for ambulance services of different service providers in urban and rural areas in Ministry of Health Malaysia
title_fullStr	Data envelopment analysis for ambulance services of different service providers in urban and rural areas in Ministry of Health Malaysia
title_full_unstemmed	Data envelopment analysis for ambulance services of different service providers in urban and rural areas in Ministry of Health Malaysia
title_sort	data envelopment analysis for ambulance services of different service providers in urban and rural areas in ministry of health malaysia
publisher	Frontiers Media SA
publishDate	2023
url	http://psasir.upm.edu.my/id/eprint/110198/ https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2022.959812/full
_version_	1811686058703716352
score	13.211869

Data envelopment analysis for ambulance services of different service providers in urban and rural areas in Ministry of Health Malaysia

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